Environmental Scan: Gender, ICT & Public Health

In general, worldwide access to Information and Communication Technologies (ICTs) is not equitable, particularly when comparing countries of the global south to those of the global north (Gurumurthy, 2004). Even within countries, access to technology is affected by social and economic circumstances of individuals and other factors such as living in rural versus urban communities. Gender is also an important determinant of access to ICTs.

Societal expectations of women, especially in less developed contexts, dictate that women should be at home or should focus on household responsibilities. Women in these circumstances will be more likely to be less educated or lack training and exposure to computers (Gurumurthy, 2004).

The Millennium Development Goal (MDG) number 3, “promote gender equality and empower women”, addresses education of women as an important target. Education impacts upon maternal health (MDG number 5) by increasing awareness of proper health seeking behaviours during pregnancy and birth, cultivating nutrition, and the use of health services. (Whyte, McCoy, Rowson 2005). Because women have a profound impact on the family unit, it is said that if a woman is educated about ICTs, it is more likely that the knowledge will be shared with the family than in educating a man (Huyer as cited in Lai, 2005).

The potential of ICT in health provision is generally still not as recognized as it should be as a method of reaching and empowering women. Programmes, policies and regulations hardly factor the different needs of men and women when it comes to the implementation of ICT programmes (Wangmo, Violina, and Haque, 2004).

ICTs can be a tool that helps to bridge the digital gender divide in health by transcending geographic barriers. This is closely linked to the concept of eHealth, which involves the use of technologies, traditional and new, in order to improve health services and access (WHO as cited in PAHO/WHO, 2011).

Apart from just clinical applications of technology (health care focused), ICTs also have immense potential for strategic communication through innovative health initiatives for marginalized women (GenderIT.org). This potential is made clear with three emerging themes which will be explored in this paper: ICT for income generation; ICT as an information dissemination and education tool in sexual and reproductive health; and the role of secondary sources, interpersonal communication and networks.

Methodology

Information searching and retrieval was conducted with peer-reviewed and non-peer reviewed documents, conference reports, events and social media. This environmental scan specifically looks at the question, “What information exists about ICTs as a tool in promoting gender equity, within the public health arena?” There is little data, which explores this particular intersection, which was admitted in a in a paper examining International Development Research Centre (IDRC) projects as they pertain to gender and eHealth (Flynn-Dapaah and Rashid 2009).

The search for non peer reviewed articles was carried out using a Google web search. Videos, News, Blogs, Discussions were also explored. For peer reviewed documents, independent literature searches in the electronic database PubMed and Web of Science with the use of common MeSH words was carried out (see Table 1 below).

Table 1. MedLine (PubMed) and Web of Science Search Terms and Hits

Key words

(“Gender Identity” OR “Sex” OR “female” OR “women” OR “men”) AND (“Socioeconomic Factors” OR “Sociology, Medical” OR “inequity” OR “inequities” OR “inequality” OR “inequalities”) AND (“Wireless Technology” OR “Remote Sensing Technology” OR “Point-of-Care Systems” OR “Telemedicine”)

(“Gender Identity” OR “Sex”) AND (“Socioeconomic Factors” OR “Sociology, Medical” OR “inequity” OR “inequities” OR “inequality” OR “inequalities”) AND (“Latin America” OR “Caribbean” OR “South America”)

Relevant content was then selected based on the following criteria:

1. The content speaks about all or most search terms outlined above

2. Content is in Latin America and the Caribbean (LAC) or can be applied to LAC

3. Content is related to public health

Then, articles were ranked in terms of relevance and a review of the most relevant content was carried out, noting common emerging themes to guide selection of main areas/topics for this environmental scan.

ICT for Income Generation & Public Health

Income generation is important to improving the well-being of households, and addressing issues of communication and control (power) in relationships. These factors impact public health issues such as HIV infection and gender-based violence.

According to Gurumurthy (2004) many non governmental organizations have launched initiatives which use e-commerce, providing a link through the internet for female artisans directly to global markets. The initiatives also tend to support marketing of their (women’s) products online by providing product information. An example of this is the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) programme. This public health and development initiative provided small-scale loans in addition to participatory training in gender awareness to women in a set of villagesin South Africa. The objective was to use a conceptual framework in order to understand how sexual behavior and gender based violence occurs in a given environment (ICT for Development Network, 2003). An initiative like this can be similarly applied in the LAC region in traditional community settings where gender inequity is prevalent.

Given the fact that gender equity is so closely linked to issues of poverty and development, projects and interventions must address these issues, alongside ICT for public health, in order to reach vulnerable and marginalized women and their households.

ICT as an information dissemination and education tool for reproductive and sexual health

ICT is already being used in the health sector of many developing countries, but the potential that ICT has for reaching the female population is still under-recognized (Gurumurthy, 2004). Studies have shown that in order to impact on the lives of women, both information and communication tools, was the key (Mayer, Pillsbury, Mukenge, 2002). Women’s groups and other organizations have therefore been supported in using ICTs to address reproductive and sexual health. One such initiative is Women Connect! (1997 to 2002) which supported women's groups in using traditional media (e.g., t-shirts, posters and brochures), mass media (radio, newspapers, magazines and television) and ICT, including e-mail and the Internet, to communicate and advocate for causes like women's reproductive and sexual health (Mayer, Pillsbury, Mukenge, 2002). This initiative was implemented through 30 NGOs in Africa (Zimbabwe, Zambia and Uganda), but the project proposes that the lessons learned can be applied to communications initiatives with women's groups throughout Latin America (Mayer, Pillsbury, Mukenge, 2002).

Television and radio have been said to be the most effective ICT for reproductive health information dissemination to women (Wangmo, Violina, and Haque, 2004). On the other hand, radio, is still in many places, the most dominant medium of communication because of its affordability (Kaphle, 2001).

The role of secondary sources, interpersonal communication and networks

Evidence has shown that women in particular, tend to seek the validation of secondary sources when it comes to seeking information related to health. These sources may include religious or traditional healers or a respected community member (World Health Organisation, 1997). Furthermore, according to Flynn-Dapaah, and Rashid (2009), “women’s reproductive health is highly influenced by the behavior and attitudes of men”[1]. Therefore, there is a need to understand how gender relations and power affect the introduction of technologies.

This reliance on secondary sources does not take away from the relevance of ICTs but it shows that ICTs can be a useful tool when combined with more "traditional” communication (World Health Organisation, 1997). Communication channels for family planning may also include mass and small media, traditional media and new communication technologies. In order to ensure that the intervention is successful, it must be focused on the target audience and sensitive to the environment or culture (World Health Organisation, 1997).

For female health workers, ICTs have the potential to facilitate and encourage collaboration between reproductive health workers and other specialists at the local level (Haile, Du Guerny, and Stloukal, 2000). An example of this is the project Linkage for Education and Research in Nursing (LEARN). This project, by supporting the use of a simple ICT infrastructure and toolkit - comprising personal digital assistants (PDAs), wireless connectivity and health-relevant software, assisted nurses in the Caribbean with point of care access to information, treatment decision-making, data collection and information sharing (Guarangochat, 2010). This kind of initiative could be replicated throughout LAC as a means of improving standards and empowering nurses by increasing access to information and knowledge ‘at their finger tips’.

Conclusion

It is clear that an important research area will be the role of ICTs for health, as a subject requiring gender specific focus and interventions (Muturi, 2005). Health policy makers developing ICT interventions have to move beyond simple rhetoric related to mainstreaming the gender perspective, to actively planning and evaluating of applications of new technologies in the health sector, as well as supporting community activities that improve women's access to health services (genderIT.org).

Research, programmes and policy (whether public or private), should include a gender analysis of health situations including: "gender indicators" for monitoring and evaluation, capacity building of professionals to integrate a gender perspective into daily work, dissemination of information to advocate for policies and programs that are more gender-sensitive and focused on increasing the participation of women in defining their health priorities (GenderIT.org).

Up to 2005, evidence in the Caribbean indicated that introducing women to computers and other technologies alone was not enough to empower, since many women continued to only use technology for the most basic functions. Social, cultural, economic and geographical issues dictate the adoption and use of the technology. These barriers can limit the potential of ICTs in addressing some critical development issues particularly associated with women and development. Muturi (2005) asserted, “ICTs by themselves cannot transform the lives of women for better or for worse. They are not an end in themselves, rather as tools that speed up the achievement of economic and social goals”[2].

Much of the literature focuses on traditional technology (TV & radio) for gender focused strategies not much about online technologies such as social media and other communication tools such as mobile phones. For example, the concept of secondary sources and ‘networks’ which not only disseminate health information, but serve as a validating voice for women should be explored using social media, which has emerged as a popular ICT.

The general dearth of studies and projects in the LAC is evident as most literature speaks to African and Asian contexts. Much of the literature cited is also dated in terms of when studies and projects were conducted. Nonetheless, the emerging themes still provide valuable insight into work that should be done in the LAC region in gender equity, ICTs and public health.

Soroya Julian is a Young Professional (YP) for the Public Health, Innovation and Equity Project in Latin America and the Caribbean (eSAC) project.

About eSAC:

eSAC aims toprovide a platform to discuss the role of information and communication technologies (ICTs) in enhancing equity in public health and addressing the social determinants of health.For more information on this report please contact info@esacproject.net or visit our website at http://en.esacproject.net.